title: New obesity agents: lorcaserin and phentermine/topiramate.
abstract: OBJECTIVE
  To evaluate the evidence for lorcaserin and phentermine/topiramate in the treatment of obesity.
  
  
  METHODS
  Literature was accessed through PubMed (June 1975-March 2013) using the search terms lorcaserin, phentermine, topiramate, or phenter mine/topiramate. Additionally, reference citations from publications identified were reviewed. Additional information was obtained from the Food and Drug Administration (FDA)-approved prescribing information and FDA briefing documents.
  
  
  METHODS
  English-language articles focusing on Phase 3 clinical trials for obesity were critiqued. Data from preclinical and Phase 1 and/or 2 trials are reported when appropriate. Six prospective Phase 3 trials were reviewed.
  
  
  RESULTS
  Obesity has reached epidemic proportions, affecting more than one third of adults in the US. Two medication products, lorcaserin and phenter mine/topiramate, have recently received FDA approval as adjuncts to a reduced-calorie diet and increased physical activity among individuals with a body mass index greater than or equal to 30 kg/m(2) or greater than or equal to 27 kg/m(2) with an obesity-related comorbidity, such as hypertension, dyslipidemia, or diabetes. Lorcaserin is a selective serotonin 5-HT2C agonist that regulates food intake, while the combination of phentermine/topiramate causes appetite suppression and enhanced satiety. Three Phase 3 randomized, placebo-controlled trials reported approximately 75% and 45% of patients achieved greater than or equal to 5% weight loss with phentermine/topiramate and lorcaserin, respectively.
  
  
  CONCLUSIONS
  With lifestyle modification, phentermine/topiramate appears most effective in terms of weight loss. Lorcaserin demonstrates moderate efficacy. Long-term cardiovascular outcomes studies are needed to confirm the safety and benefit of these new obesity agents.
authors.affiliation: Department of Pharmacy Practice, School of Pharmacy, University of Mississippi, Jackson, MS, USA.
authors.forename: Joshua W
authors.initials: JW
authors.lastname: Fleming
authors.forename: Katie S
authors.initials: KS
authors.lastname: McClendon
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Riche
mesh_terms: D000818:Animals; D019440:Anti-Obesity Agents / Q000008:administration & dosage*; D001552:Benzazepines / Q000008:administration & dosage*; D002986:Clinical Trials as Topic / Q000379:methods; D004359:Drug Therapy, Combination; D005632:Fructose / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D009765:Obesity / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D010645:Phentermine / Q000008:administration & dosage*; D000077236:Topiramate; D015431:Weight Loss / Q000187:drug effects / Q000502:physiology
chemical_list: D019440:Anti-Obesity Agents; D001552:Benzazepines; D000077236:Topiramate; D005632:Fructose; C506658:lorcaserin; D010645:Phentermine